Individual provider Active NPI

Vinu Devasia

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1881051639
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096573 Issued in NY
Practice address
1419 Shakespeare Ave
Bronx, NY 10452-1851
Phone
(718) 732-7080
Fax
(718) 732-7090
NPI assigned
Jan 25, 2016
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 096573 NY Primary

Addresses

Primary practice location

1419 Shakespeare Ave
Bronx, NY 10452-1851

Mailing address

18 Glen Haven Dr
New City, NY 10956-5837
Phone (845) 708-5698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
096573NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1881051639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 GLEN HAVEN DR",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565837",
            "telephone_number": "845-708-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 SHAKESPEARE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104521851",
            "telephone_number": "718-732-7080",
            "fax_number": "718-732-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVASIA",
        "first_name": "VINU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.